Streamlining Cancer Service Capacity

As the Government enacts major changes to the way the health service is run at a national level, it’s important not to get distracted and delay dealing with the challenges facing the frontline of cancer care today.

The NHS is facing growing challenges when it comes to capacity to deliver cancer care. This is widely recognised within the cancer community. It was a dominant topic at the HSJ Cancer Forum in March this year, as well as last November’s annual UK SACT Board conference.

What does this mean for patients? The National Cancer Audit Collaborating Centre (NatCan) recently warned of the variations in care meaning that, for some cancers, up to half of patients are not receiving nationally-recommended treatments.¹ One of the key drivers of this is capacity.

Many of these issues have been raised by The Royal College of Radiologists’ work on the capacity crisis in Systemic Anti-Cancer Treatment (SACT) services, which has triggered national action on the issue.^2,3 However, the challenges are acute, and affect the whole patient pathway including:

• Referrals: Urgent suspected cancer referrals have risen 30% from pre-pandemic levels,⁴ meaning more people are entering the pathway, and with record numbers being diagnosed with cancer, more patients are progressing to treatment⁵
• Diagnostics: Biomarker tests can be beneficial for securing an early and accurate cancer diagnosis. However, a recent NHS England Board paper highlights that the increase in genomic testing activity in the NHS has impacted on turnaround times⁶
• Treatment: Demand for SACT increased by 14% between 2019 and 2023.⁷ This demand is driven not only by new diagnoses, but also by more patients living longer on active treatment⁸

AstraZeneca is proud to be part of an industry that is bringing a breadth of oncology innovation to the NHS: almost half of new drugs appraised by NICE are for cancer.⁹ But we recognise that patients can only benefit from the remarkable advances in cancer care if the system has sufficient capacity to deliver timely, high-quality services

Our new cancer capacity case study reports build on the recommendations of Incisive Health’s independent Capacity to Deliver report,¹⁰ which AstraZeneca initiated and funded in 2023. The case studies showcase good practice, identify scalable solutions and set out policy recommendations to help the NHS and the Government deliver on their commitment to cut waiting times.

Recommendations include:

1. Harnessing technology: the Department of Health and Social Care should review and enhance the use of technology, including AI, to streamline cancer referrals and diagnostic pathways. Leveraging technology can improve efficiency and free up staff capacity for critical patient care.
2. Diversifying workforce skills: the Government should evaluate and implement further opportunities for staff, such as nurses and pharmacists, to deliver more aspects of cancer treatment. Expanding workforce roles can alleviate pressure on clinical teams and ensure timely care for more patients.
3. Collaborating with industry: establishing a clear framework for partnerships with the life sciences industry will help the NHS to build system readiness for innovations like complex biomarker tests. These partnerships are essential to fully leverage advances in cancer diagnostics, treatment and care.
4. Scaling successful innovations: policymakers should identify and roll out proven, high-impact interventions being piloted by local systems. Scaling these off-the-shelf solutions nationally can unlock capacity savings and ensure the best practices benefit all patients.
5. Introducing a new approach to incentives: policymakers should take a new approach to incentives that invites and rewards innovation in the NHS. Incentivising innovation can unlock resources to improve cancer outcomes.

Addressing the NHS’s capacity challenge and delivering on the Government’s ambitions to recover waiting time targets requires bold, coordinated action across the NHS. By embracing technology, diversifying the workforce, fostering industry collaboration, and scaling successful innovations, the NHS can work to ensure that no patient misses out on the promise of modern cancer care.

You can read the three capacity case study reports here:

1. Optimising referrals and triage
2. Biomarker testing
3. Systemic Anti-Cancer Therapies